What would cause + ana nucleolar pattern on 4 tests low titer and now completely negative?

Hard to interpret: Antinuclear antibody tests are famously inconsistent because even when they are done correctly by the lab (and often they are not), the immune system is chaotic and results can vary tremendously from week to week. Ana's, especially at low titer, mean nothing apart from the clinical picture. Try to stay physically fit, and forget about the ANA unless your physician is super-concerned.